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64 Cards in this Set
- Front
- Back
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Which are the accomodative, nonnstrabismic anomalies that can be managed with lenses and prisms |
Accomodative insufficiency Convergence excess Divergence insufficiency Basic esophoria Vertical hererophoria whic |
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Which conditions are best treated with vt? |
Convergence insufficiency Divergence excess Fusional vergence dysfunction Basic exophoria Accomodative excess Accomodative infacility Oculomotor dysfunction |
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Physiologic changes achieved thru VT |
Decreased latency and increases accuracy and speed of accomodative response CI increase in PFV CE increase in NFV OMD increase in speed and accuracy |
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in the CISS which is a significantly symptomatic score? |
children= more than 16 adults= more than 21 |
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in CISS what is considered a successful VT? |
below 16 or 21 or having a change of more than 10 |
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in the VOVD which is a symptomatic score? |
20 or higher. |
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Saccades always initiate as? |
Magnocelllular and end at parvocellular |
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magnocellular is |
sensitive to illumination levels but not to color |
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parvo cellular is |
sensitive to color |
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up to how much is a saccade's velocity? |
700 deg/sec |
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avg latency of a saccade is? |
200 ms |
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where does the involuntary saccades pathway start? |
in the Contralateral broadman area 8 in the frontal eye fields |
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where does the involuntary saccades pathway terminate? |
in the nuclei of the 3rd, 4th and 6th cranial nerves |
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where do voluntary saccades initiate? |
in the Occipital-parietal junction and the rest of the pathway is the same as involuntary saccades. |
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how much saccades does reading involve? |
10% |
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what is the amplitude of a reading saccade? |
1-15º average is 2º that is 8-9 character spaces |
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what is the average speed of a 2º saccade? |
25-30ms |
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what are fixations? |
the time in between saccades its the time when you are actually reading accounts for 80% of reading time speed 200-250 |
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In what direction do regressions go in the western world? |
right to left because we read left to right |
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What causes slow saccades? |
internuclear opthalmoplegia (INO) or CN3 or CN6 |
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InterNuclear opthalmoplegia is characterized by: |
diplopia limited adduction in one eye nystagmus towards the side of the affected eye |
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INO can also cause a |
fast saccade- one eye is faster than the other. |
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Which saccade is related to MG in which a pt replaces saccade with a smaller amplitude saccade? |
truncated saccade- unable to complete saccade |
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Wallengberg syndrome is asoc w/ what accuracy problem? |
Dysmetria- series of small saccades. also asoc w/ cerebellar problems |
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what is hypometria? |
incomplete saccades asoc. w ALzheimers or VF defects (usually right hemianopsias) |
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Hypermetria? |
overshoot with regression saccade asoc with VF defects (right hemianiopsias) |
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whch accuracy problems are asoc with RIGHT HEMIANOPSIAS? |
Hypometria and hypermetria |
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what is oculomotor Apraxia? |
increased latency and uses a series of small saccades if acquired is due a parietal lesion, early parkinson's disease |
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Inapropriate saccades are: |
always cerebellar square-wave saccades: 1-5º macro-square saccades: 10-40º DO NOT HAVE PURSUITS |
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Some inapropriate saccades are: |
ocular flutter- spring action, when the saccade tries to stop using smaller ones. opsoclonus- random saccades in diff directions that occur in episodes |
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Readalizer is an automated test that? |
shows the saccade and fixation eye movements of the pt while reading |
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Whats a good reader pattern in the Readalizer (visograph)? |
stair case pattern with a regular pattern of saccade-fixation-saccade second part of the test is questions to determine understanding. a poor reader may show an irregular pattern with regressions |
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In every normative test what is a failing score? |
a percentile rank of less or equal to 15 or a SD larger than -1 ( so a SD of -9 is a passing one) |
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What test uses normative data according to age (5-14) and gender? |
NSUCO automated it compares the patient with the rest of the population based on demographics. |
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What test do you use to see if an athlete has a concussion? |
King Devick (NYSOA) Sacadic test if there is a significant reduction in performacne the doctor has evidence that a concussion is present. |
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What does the King Devick tests for? |
• rapid automated naming-ability to see and verbalize what is seen. • Short term visual memory • general spatial awareness • saccades • attention |
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King Devick score is based on? |
The time it took to complete the test observations about: head movement finger pointing posture facial expression |
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Developmental eye movement is used to: |
determine if the pts reading difficulty is due to saccadic dysfunction, automaticity or BOTH |
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What does a DEM pretest consist of? |
done if pt under 12 y/o arranged horizontally pt must read outloud in 12 secs or less with no mistakes. if pt passes go do test a and b |
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What do tests A and B test for? |
they test for AUTOMATICITY ONLY |
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in tests A and B Total vertical time = |
Ta + Tb |
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Describe test A and B? |
a vertical array of 40 letters in each test so its 80 letters in total. |
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Describe Test C: |
Horizontal array of 80 numbers must record time, omissions, additions, transpositions and substitutions |
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What does test C test for? |
saccades AND automaticity |
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whats the z-score |
Its the place within the normative bell curve where the pts results are plotted |
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Type 1 is? |
Normal normal vertical and horizontal z scores and time are close to the mean |
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Type 2 is |
Saccadic dysfunction (OMD) in creased horizontal time w/ normal vertical negative horizontal z-score= more time in horizontal |
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Type 3 is |
Poor automaticity or expressive language problem normal or close to normal ratio but BOTH horizontal and vertical times are over the mean close negative z-scores for horizontal and vertical |
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Type 4 is |
OMD and Automaticity problem high ratio: high numerical vertical but LARGER numerical time for horizontal neg vertical z-score but larger neg horizontal z-score WORST PROGNOSIS |
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what are the signs of saccadic dysfunction? |
score below 15th percentile (z-score less than -1.00) on DEM below age-level perormance on visagraph below age-expected norms in NSUCO |
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Avg velocity of a pursuit is? |
30-60 deg per sec |
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What is the latency of pursuits? |
130ms so longer than saccades |
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where do pursuits initiate? |
at the cortex saccades initiate at the frontal lobe |
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this eye movement is centrally mediated ONLY |
Pursuits you visually identify the obj w/ the fovea and then you follow it. |
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que parte del cerebro se ve afectada cuando hay un saccade dysfunction? |
el frontal lobe |
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que parte del cerebro se ve afectada cuando hay un pursuit dysfunction? |
el occipital lobe-- its where the pursuit starts |
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what is the most common acquired pursuit? |
Cogwheeling- deficient pursuits compensated by series of small saccades. pt will always be behind moving target seen in parkinsons and cerebellar diseases |
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What is a slow gain? |
when the pt is unable to match the velocity of the obj, so its always lagging behind the target |
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Slow gains are due: |
most commonly aging medications that impair pursuits |
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what medications impair pursuits? |
Diazepam phenytoin phenobarbital and barbiturates methadone alcohol and marihuana chloralhydrate (common w/ pediatrics) |
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Describe Groffman visual tracing |
standardized according to age (6-12) pt visually traces the ine from a letter and tells at which picture it ends score is given only if the answer is correct and done in under 60s |
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Techniques that provide feedback |
Diplopia Blur Suppression Luster/color fusion Kinesthetic awareness SILO Float Localization Parallax |
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What is a significant symptomatic score in CISS? |
Children= more than 16 Adults=more than 21 |
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In CISS what score is considered a successful VT? |
Below 16 or 21 Or Having a change of more than 10 |
